Preterm birth continues to be one of the most important issues in current obstetric medicine, being the single largest cause of perinatal morbidity and mortality. The signals that initiate preterm and term labour remain a mystery. Intrauterine inflammation with the secretion of cytokines is one of the accepted explanations for the mechanism of initiation of preterm labour. This review discusses...

We previously investigated the progesterone metabolite 5β-dihydroprogesterone (5βDHP) in relation to human parturition at term, demonstrating that peripheral venous concentrations decrease in association with the onset of spontaneous labour. In this study our aim was to determine if 5βDHP concentrations were lower in women presenting in spontaneous preterm labour than in controls matched for ge...

BACKGROUND Preterm birth is the primary cause of the neonatal mortality and morbidity. There will be no preterm birth without a cervical softening. Nitric oxide (NO) is shown to be a mediator of term cervical ripening. The aim of this study was to investigate mRNA expression of the three isomers of NO synthases (NOS) and to identify them by immunohistochemistry in the human cervix at preterm bi...

Despite scientific advances, efforts to prevent preterm birth can be disappointing. Obstetric care must focus on strategies to improve the outcome of preterm infants. The major goal is to delay preterm birth long enough to allow the transfer of women about to deliver preterm to a facility with a neonatal intensive care unit and to administer corticosteroids to enhance fetal lung maturation. A p...

We hypothesized that the priming and activation of maternal leukocytes in peripheral blood is a key component of parturition, and that inappropriate preterm priming of leukocytes might initiate preterm labour and delivery. The purpose of this study was to characterize peripheral blood leukocyte activation during human term and preterm labour. We obtained blood samples from pregnant women at ter...

Parturition is composed of five separate but integrated physiological events: fetal membrane rupture, cervical dilatation, myometrial contractility, placental separation, and uterine involution. Prostaglandins (PGs) have central roles in each of these events, but the most studied is myometrial contraction. Elevated uterine PGs or the enhanced sensitivity of the myometrium to PGs leads to contra...

background and aim: horseshoe placenta is a variant of ring-shaped placenta. ring-shaped placenta is a rare anomaly seen in fewer than 1 in 6000 deliveries, which could be seen as horseshoe shape due to atrophy in a portion of the ring. this report refers to a possible relationship between the horseshoe shape placenta and preterm labor; although it has not been yet validated in the literature. ...

Preterm delivery (<37 weeks of gestation) is the major obstetrical complication in developed countries, yet attempts to delay labour and prolong pregnancy have largely been unsuccessful. One of the many reasons it is so difficult to prevent preterm birth is that the nature of preterm labour changes as a function of gestational age, maternal lifestyle factors or infection, to list a few of the r...

Moderate and late preterm births account for the majority of preterm babies. The common perception that birth at 32-36 weeks' gestation carries few risks is now being challenged, as these babies have increased risk of neonatal mortality and morbidity. However, spontaneous labour at this gestation frequently has no specific, easily identifiable precursor, although preterm birth per se has a numb...

This paper reports on an innovation, within a maternity unit, to introduce a fetal fibronectin, point of care test, that will aid the clinician in correctly diagnosing preterm labour. In turn this will assist in developing an individual plan of care for each woman with suspected preterm labour, rather than treating each case with the same interventions regardless of subsequent outcomes. Fetal f...